People with both Medicare and Medicaid may qualify for a Dual-Eligible Special Needs Plan (D-SNP) — frequently $0 premium, built around extra benefits. Here's how it works in plain English, then free help from a licensed local agent if you want it.
You're 'dual-eligible' when you qualify for BOTH Medicare (usually age 65+ or a qualifying disability) and Medicaid (a state program based on income and resources). Millions of people have both and don't realize the door it can open.
A Dual-Eligible Special Needs Plan is a type of Medicare Advantage plan designed specifically for people with both Medicare and Medicaid. Because Medicaid covers much of the cost-sharing, these plans are frequently $0 premium and often add benefits Original Medicare doesn't.
Many D-SNPs include things like dental, vision and hearing, an over-the-counter allowance for everyday items, and rides to medical appointments. Exactly what's offered varies by plan and by county — that's worth comparing carefully.
Unlike most people who can only switch during the fall Annual Enrollment Period, people with both Medicare and Medicaid often qualify for special enrollment periods that let them change plans more than once a year. A licensed agent can tell you when your window is open.
What you qualify for depends on your Medicaid level and the plans offered in your county. A licensed agent can check both with you — free, no obligation. We do not offer every plan available in your area. We are not affiliated with or endorsed by Medicare, Medicaid, or any government agency.
If you have both Medicare and Medicaid, a lot of the mail you get is trying to push one specific plan. That's not what this is. LeadLoom simply connects you with a licensed local agent who can check whether you qualify for a Dual-Eligible Special Needs Plan, explain the extra benefits in your county, and answer your questions — at no cost and with no obligation to enroll in anything.
You're generally dual-eligible if you have Medicare (Parts A and/or B) and also qualify for Medicaid or a Medicare Savings Program (like QMB) through your state, which is based on your income and resources. If you already have a Medicaid card or get help paying your Part B premium, you may qualify. A licensed agent can confirm your status with you for free.
Many D-SNPs have a $0 monthly premium because Medicaid covers much of the cost-sharing, but that isn't guaranteed for everyone — it depends on your specific Medicaid level and the plans offered in your county. The only way to know what you'd actually pay is to compare the plans available to you.
Enrolling in a D-SNP does not take away your Medicaid. Whether your doctors are in a given plan's network varies plan by plan, so it's worth checking before you change anything — a licensed agent can look that up with you.
The help is free and there's no obligation. We are not affiliated with or endorsed by Medicare, Medicaid, or any government agency. A licensed agent earns a commission from the insurer only if you choose to enroll — it never costs you more, and you can always contact Medicare.gov, 1-800-MEDICARE, or your state Medicaid office directly.